Pelvic mass with no cancer cells in ascites

We have been on a rollercoaster ride since 5/1, my Mom went to the ER with stomach bloating which rapidly grew over the course of 2 weeks, CT revealed large pelvic mass possibly ovarian 25x20x17 coupled with large hiatal hernia. Diagnosis based on presentation, age 68, tumor markers was advanced ovarian cancer. Ascites has been building up in abdomen, surgery was scheduled prior to chemo, then changed given the fact that my Mom's platelets were very high, we did platelete extraction and got the platelets down to a normal level. Surgery was called off day of. Ascites fluid was drained 3 liters which was causing extreme discomfort, spun down, results came back this evening from pathology that fluid was negative, no cancer cells, not one. Biopsy will be done on Monday. I am hoping this is a good sign I know we need to wait, they were going to start chemo today but results have it on hold till after results from biopsy. Is that fact that no cancer cells found in the ascites a good sign?

They don't usually do a biopsy of the mass because they don't want to rupture it and have cancer cells leak into the pelvis.

Whether or not she has cancer, you want a gynecological oncologist involved in this case. A gyn/onc has years more specific training and experience than a general oncologist or a general surgeon or even a gyn surgeon. Can't stress this enough. It's important to get things off to a good start.

No cancer cells in the ascites sounds encouraging. If there's cancer in the mass, regardless of stage, she would probably avoid the dreaded "C" in the designation. ("A" means one ovary and "B" means both ovaries. There are also different stages -- 1 to 4, the most extensive.)

I'm sorry you and your mom are going through this, and I hope the mass is benign. But I want you to know that are are women on this forum who are stage 3 or 4 that have had lengthy (years) remissions or have been treated as "chronic" for several years. Good luck!

Hi, I am an RN and my wife was recently Dx with granulosa Cell cancer( GCT) Jan 2010. Tests like sonograms, Cat scans and MRI's along with blood tests like CA125, Inhibin A&B, MIS and CEA are just used as a guides for the Dr's to help assist in making a diagnoses(Dx). The test you describe CA-125 is a test used by Dr's as a guide to determine if you have the most common form of ovarian cancer, approximately 80% of all ovarian cancers are epitheal ovarian cancer which is cancer of the cells on the surface of your ovary. Please keep in mind that CA-125 can be elevated if your menstruating and some other cuases of inflamation (inflammation)..
There are other types of ovarian cancer that are hormone driven and depending which form a person has there will be excess symptoms of that specific hormone. This is the type my wife was Dx with granulosa cell ca. These group type are called sex cord -stromal tumors. These type of tumors have specific markes that the Dr's use just like ca-125 to aide in their dx of epitheal ovarian ca. They are Inhibin A&B and MIS. Please keep in mind if and only if you have a dx of these form of tumors there is a missconception that these tumors are always benign, which is completely false> They are just slow growing tumors as opposed to epitheal.
Unfortunately with any type of suspected ovarian mass/tumor surgery will be the only way for the Dr's too make a definitive Dx. It is NOT recommended to biopsy any ovarian mass as it will rupture and seed the pelvis with cancer cells if that what it turns out to be. Either way this mass/tumor has to removed surgically so again a biopsy of an ovarian mass is not the standard of care!!!!!!
Please make sure they drew her blood for the following blood tests,Inhibin A&B, CA125 and CEA so at the very least you have baseline blood work.
Since there is suspicion based on your description as shewrites stated I would immediately find a good GYN/Oncologist surgeon. I would reccomend going to a large tiertiary hopsital where they see large volumes of patients. This is not to make you worry even more but to make sure that the Dr who treats your mom has vast experience with diagnosing and treating various types of GYN / Onc issues if that is what it turns out to be. If the Dr wants to remove the cyst/mass via laprascopic procedure PLEASE make sure they have much experience with removing these INTACT! All too often I read posts from patients who say their Dr thought it was a cyst and removed it haphazardly causing a rupture and seeding of the pelvis with cancer cells, only to be found on pathology post removal.
Next: From experience I would be asking for an MRI of the abdomen/pelvis ,MRI's are very precise when read by a Radiologist that specializes in GYN/ONC, My wife went to a radiology practice that does all types of MRI's and the Radiologist read her MRI as a fibroid. I then took her to Sloan Kettering in NYC to see a GYN/ONC surgeon Dr Carol Brown who had the MRI repeated by a GYN/ONC Radiologist who called her DX to the tee which was confirmed after surgery.
The best advice you see all over these posts is you have to be your own advocate, be aggresive (aggressive) and stay on top of your phycicians. Get copies of all your tests/results as you are entitled to them. Post with any other questions you have this site has some very knowledgeable people on it. I wish you all the best
Kevin

Thank you both so much for your information, it helped. Mom had the biopsy today and they drained more fluid of course nothing is promised on time and it seems to all be hurry up and wait. Tomorrow we should know the type we are dealing with but your posts were extremely helpful. We do have an excellent surgical oncologist and hematologist oncologist so we will await the results and hopefully start on a course of action. This all just happened so fast, so scary and we are just trying to take it day by day, it is frustrating at times as nothing seems to happen when promised and being delayed makes you worry even more. I am so glad I found this forum. Thank you all

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